Phenotypic and genotypic detection of carbapenemase production among gram negative bacteria isolated from hospital acquired infections

Document Type

Article

Publication Title

Saudi Medical Journal

Abstract

Objectives: To identify the carbapenemase producing Gram-negative bacteria)GNB(by phenotypic methods and to confirm the presence of resistant genes using real-time polymerase chain reaction)PCR(. Methods: This was a prospective study carried out at the Department of Microbiology, Sri Venkata Sai Medical College and Hospital, Mahabubnagar, India, from March 2018-2021. All samples were screened for carbapenem resistance by disc diffusion method and the VITEK®2 compact system)bioMérieux, France(. Detection of carbapenemase was carried out using RAPIDEC®CARBA NP test)Biomeriux Private Limited, South Delhi, India(, screening for metallo-β-lactamases)MBL(was carried out by double disk synergy test)DDST(, and genotypic characterization by real-time PCR. Results: Among the 1093 Gram-negative bacilli identified, 220)17.0%(were resistant to carbapenems by both tested methods. Carbapenemase detection using the RAPIDEC®CARBA NP test indicated that 207)94.0%(were carbapenemase producers, of which 189)91.2%(were MBL producers. The most common carbapenemase genes identified were New Delhi metallo-β-lactamase)NDM; 47.3%(, followed by the co-existence of genes in combination of NDM, with Verona integron-mediated metallo-β-lactamase)VIM; 39.6%(, VIM and oxacillin hydrolyzing enzymes-48)OXA-48; 4.3%(, and OXA-48)1.4%(.No gene of active on imipenem, Klebsiella pneumonia carbapenemase, VIM, or OXA-48 alone was detected. Conclusion: This study suggests routine carbapenem resistance testing among multi-drug resistant-GNBs, as most of these infections occur in hospitals. In addition, there is a possibility that these highly antibiotic-resistant genes could spread to other bacteria resulting in further dissemination.

First Page

236

Last Page

243

DOI

10.15537/SMJ.2022.43.3.20210809

Publication Date

3-1-2022

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